Whitfield Geoffrey P, Meehan Leslie A, Maizlish Neil, Wendel Arthur M
Centers for Disease Control and Prevention, National Center for Environmental Health, Healthy Community Design Initiative.
Tennessee Department of Health, Office of Primary Prevention.
J Transp Health. 2017 Jun;5:172-181. doi: 10.1016/j.jth.2016.06.009. Epub 2016 Jul 22.
The Integrated Transport and Health Impact Model (ITHIM) is a comprehensive tool that estimates the hypothetical health effects of transportation mode shifts through changes to physical activity, air pollution, and injuries. The purpose of this paper is to describe the implementation of ITHIM in greater Nashville, Tennessee (USA), describe important lessons learned, and serve as an implementation guide for other practitioners and researchers interested in running ITHIM. As might be expected in other metropolitan areas in the US, not all the required calibration data was available locally. We utilized data from local, state, and federal sources to fulfill the 14 ITHIM calibration items, which include disease burdens, travel habits, physical activity participation, air pollution levels, and traffic injuries and fatalities. Three scenarios were developed that modeled stepwise increases in walking and bicycling, and one that modeled reductions in car travel. Cost savings estimates were calculated by scaling national-level, disease-specific direct treatment costs and indirect lost productivity costs to the greater Nashville population of approximately 1.5 million. Implementation required approximately one year of intermittent, part-time work. Across the range of scenarios, results suggested that 24 to 123 deaths per year could be averted in the region through a 1%-5% reduction in the burden of several chronic diseases. This translated into $10-$63 million in estimated direct and indirect cost savings per year. Implementing ITHIM in greater Nashville has provided local decision makers with important information on the potential health effects of transportation choices. Other jurisdictions interested in ITHIM might find the Nashville example as a useful guide to streamline the effort required to calibrate and run the model.
综合交通与健康影响模型（ITHIM）是一种综合工具，可通过身体活动、空气污染和伤害情况的变化来估算交通方式转变对健康的假设影响。本文旨在描述ITHIM在美国田纳西州大纳什维尔地区的实施情况，介绍重要的经验教训，并为其他有兴趣运行ITHIM的从业者和研究人员提供实施指南。正如在美国其他大都市地区可能预期的那样，并非所有所需的校准数据在当地都可获取。我们利用了来自地方、州和联邦来源的数据来满足ITHIM的14项校准项目，这些项目包括疾病负担、出行习惯、身体活动参与情况、空气污染水平以及交通伤害和死亡情况。制定了三种情景，模拟步行和骑自行车的逐步增加，以及一种模拟汽车出行减少的情景。通过将国家级、特定疾病的直接治疗成本和间接生产力损失成本按比例调整至大纳什维尔地区约150万人口，计算出成本节约估计值。实施工作需要大约一年的间歇性兼职工作。在所有情景中，结果表明，通过将几种慢性病的负担降低1%-5%，该地区每年可避免24至123例死亡。这转化为每年估计直接和间接成本节约1000万至6300万美元。在大纳什维尔地区实施ITHIM为当地决策者提供了有关交通选择潜在健康影响的重要信息。其他对ITHIM感兴趣的辖区可能会发现纳什维尔的例子是简化校准和运行该模型所需工作的有用指南。
